School Clinics Get $95 Million Federal Boost

More than 275 school districts, clinics, and hospitals that run school-based health centers nationwide learned Thursday that they had won a share of $95 million in federal grant money that will allow them to reach hundreds of thousands more patients, many of whom live in low-income communities.

The centers, which now serve 790,000 patients, will be able to boost their overall capacity by 440,000 patients with the grants, federal officials said as they announced the recipients. The 278 winners were chosen from 356 applicants through a program created by last year’s health care reform law.

U.S. Secretary of Education Arne Duncan hailed the grants as potentially life-changing for some students, and noted his own experience with the centers in Chicago.

School-based health centers, which have been in some communities for decades, can make it possible for children with severe and chronic illnesses to attend school and can improve the health and wellness of the entire student population through health screenings, health promotion, and disease-prevention activities.

U.S. Secretary of Health and Human Services Kathleen Sebelius said it can be difficult for some children to access health care because of challenges scheduling and paying for doctor visits. Working parents or families without cars may have an especially hard time getting their children medical care, she told reporters.

“The health care law makes it easier to get the health care [students] need to be successful,” Ms. Sebelius said.

The remaining grant money in the $200 million School-Based Health Center Capital Program will be awarded over the next two years. Each grant was limited to $500,000, and each application could include up to 10 projects.

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The money can only be used for construction and equipment for new and existing school-based health care centers, not operating costs. Applicants had to show they could provide the staff at the centers to match their capacity, although other grant money from the Health Resources and Services Administration, part of the U.S. Department of Health and Human Services, is available for some organizations that sponsor school-based health centers.

The grants were in jeopardy earlier this year. In May, the U.S. House of Representatives voted to eliminate funding for the program, but the bill was never taken up by the Senate.

Timely Aid

The infusion of federal dollars comes at a time when some health care centers at schools across the country have closed and others are on the verge of closing because the agencies that pay for them are strapped for cash, said Adrienne Ammerman, a spokeswoman for the National Assembly on School-Based Health Care.

Any more closures would reverse a trend of growth her organization has tracked for many years. During her organization’s last census of school-based health centers four years ago, 1,909 clinics and programs were counted, 300 more than in its 2004 census.

The 2007 count found that Florida had the most centers, with 245, but some less populous states had a significant share of programs, too, such as Connecticut and New Mexico with 79 each and West Virginia with 50.

“This funding means a lot,” Ms. Ammerman said. “Times are tough. For some of the grantees, they’re going to be able to spend this money on things they really need, like exam tables and dental equipment. That frees up other funding for, say, keeping their nurse practitioner on board.”

While many centers are located at schools and primarily serve students, more are opening their doors to the surrounding community, she said, which is critical now. “Health insurance costs have been going up, and parents have been losing jobs and employer-sponsored health coverage,” Ms. Ammerman added.

One of the grant winners is the Los Angeles Unified School District, which has 35 school health centers, 10 of which are run by the school district. The school district applied for a $490,000 grant to renovate one of them, at Roosevelt High School in the eastern part of the city, said Kimberly Uyeda, student medical services director for LAUSD.

Roosevelt is in “a low-income community with very significant access-to-health-care issues,” Dr. Uyeda said.

During the recent nine-month school year, the center treated students 2,500 times. “Without the opportunity to get the grant, we wouldn’t be able to renovate any school health center,” she said.

The grant money will pay for renovations that would create more exam rooms and allow the clinic to put a greater emphasis on mental and behavioral health, she said. And the expansion would allow Roosevelt to offer more services after hours for the community. In addition, the district will be able to use some of the money to create a system of electronic health records for students across the district.

A study published in March by researchers in Washington state found that high school students who used school-based health centers were somewhat less likely to drop out, and more likely to delay dropping out of school, than peers who did not use those centers.

The dropout rate for clinic-users was 15 percent, compared with 27 percent for the district in the study, which was published in the Archives of Pediatric and Adolescent Medicine.

While the researchers acknowledged that there are many other influences on student dropout rates, they said providing greater access to health services should be considered among other comprehensive dropout-prevention strategies.

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